A remarkable article appears in the June 2014 issue of the American Journal of Public Health. (Also available as free PDF here.)
The authors, experts in public health, are listed with all their academic credentials: William H. Wiist, DHSc, MPH, MS, Kathy Barker, PhD, Neil Arya, MD, Jon Rohde, MD, Martin Donohoe, MD, Shelley White, PhD, MPH, Pauline Lubens, MPH, Geraldine Gorman, RN, PhD, and Amy Hagopian, PhD.
Some highlights and commentary:
"In 2009 the American Public Health Association (APHA) approved the policy statement, 'The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War.' . . . In response to the APHA policy, in 2011, a working group on Teaching the Primary Prevention of War, which included the authors of this article, grew . . . ."
"Since the end of World War II, there have been 248 armed conflicts in 153 locations around the world. The United States launched 201 overseas military operations between the end of World War II and 2001, and since then, others, including Afghanistan and Iraq. During the 20th century, 190 million deaths could be directly and indirectly related to war -- more than in the previous 4 centuries."
These facts, footnoted in the article, are more useful than ever in the face of the current academic trend in the United States of proclaiming the death of war. By re-categorizing many wars as other things, minimizing death counts, and viewing deaths as proportions of the global population rather than of a local population or as absolute numbers, various authors have tried to claim that war is vanishing. Of course, war could and should vanish, but that is only likely to happen if we find the drive and the resources to make it happen.
"The proportion of civilian deaths and the methods for classifying deaths as civilian are debated, but civilian war deaths constitute 85% to 90% of casualties caused by war, with about 10 civilians dying for every combatant killed in battle. The death toll (mostly civilian) resulting from the recent war in Iraq is contested, with estimates of 124,000 to 655,000 to more than"a million, and finally most recently settling on roughly a half million. Civilians have been targeted for death and for sexual violence in some contemporary conflicts. Seventy percent to 90% of the victims of the 110 million landmines planted since 1960 in 70 countries were civilians."
This, too, is critical, as a top defense of war is that it must be used to prevent something worse, called genocide. Not only does militarism generate genocide rather than preventing it, but the distinction between war and genocide is a very fine one at best. The article goes on to cite just some of the health effects of war, of which I will cite just some highlights:
"The World Health Organization (WHO) Commission on the Social Determinants of Health pointed out that war affects children's health, leads to displacement and migration, and diminishes agricultural productivity. Child and maternal mortality, vaccination rates, birth outcomes, and water quality and sanitation are worse in conflict zones. War has contributed to preventing eradication of polio, may facilitate the spread of HIV/ AIDS, and has decreased availability of health professionals. In addition, landmines cause psychosocial and physical consequences, and pose a threat to food security by rendering agricultural land useless. . . .
"Approximately 17,300 nuclear weapons are presently deployed in at least 9 countries (including 4300 US and Russian operational warheads, many of which can be launched and reach their targets within 45 minutes). Even an accidental missile launch could lead to the greatest global public health disaster in recorded history.
"Despite the many health effects of war, there are no grant funds from the Centers for Disease Control and Prevention or the National Institutes of Health devoted to the prevention of war, and most schools of public health do not include the prevention of war in the curriculum."
Now, there is a huge gap in our society that I bet most readers hadn't noticed, despite its perfect logic and obvious importance! Why should public health professionals be working to prevent war? The authors explain:
"Public health professionals are uniquely qualified for involvement in the prevention of war on the basis of their skills in epidemiology; identifying risk and protective factors; planning, developing, monitoring, and evaluating prevention strategies; management of programs and services; policy analysis and development; environmental assessment and remediation; and health advocacy. Some public health workers have knowledge of the effects of war from personal exposure to violent conflict or from working with patients and communities in armed conflict situations. Public health also provides a common ground around which many disciplines are willing to come together to form alliances for the prevention of war. The voice of public health is often heard as a force for public good." Through regular collection and review of health indicators public health can provide early warnings of the risk for violent conflict. Public health can also describe the health effects of war, frame the discussion about wars and their funding . . . and expose the militarism that often leads to armed conflict and incites public fervor for war."
About that militarism. What is it?
"Militarism is the deliberate extension of military objectives and rationale into shaping the culture, politics, and economics of civilian life so that war and the preparation for war is normalized, and the development and maintenance of strong military institutions is prioritized. Militarism is an excessive reliance on"a strong military power and the threat of force as a legitimate means of pursuing policy goals in difficult international relations. It glorifies warriors, gives strong allegiance to the military as the ultimate guarantor of freedom and safety, and reveres military morals and ethics as being above criticism. Militarism instigates civilian society's adoption of military concepts, behaviors, myths, and language as its own. Studies show that militarism is positively correlated with conservatism, nationalism, religiosity, patriotism, and with an authoritarian personality, and negatively related to respect for civil liberties, tolerance of dissent, democratic principles, sympathy and welfare toward the troubled and poor, and foreign aid for poorer nations. Militarism subordinates other societal interests, including health, to the interests of the military."
And does the United States suffer from it?
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